Pancreas Surgery Saves Babies in Sudan Despite Limited Resources

In a hospital in Sudan, physicians confronted a formidable challenge: treating newborns whose insulin secretion drives dangerously low blood sugar levels. The condition, congenital hyperinsulinism (CHI), can be life‑threatening if not addressed promptly.

Diagnostic Constraints

• Limited technology: The country lacks advanced tools, making it difficult to determine whether CHI is localized or diffuse.
• Absence of rapid genetic testing and detailed imaging: In better-equipped settings, these diagnostics guide treatment decisions. Here, surgeons often act without full information.

Surgical Intervention (2019–2024)

• 32 infants underwent near‑total pancreatectomy.
• Demographics:
• 60 % were girls.
• Most (≈ 70 %) diagnosed within the first week of life.
• Medical therapy:
• Nearly all received diazoxide; only ~25 % responded.
• Diagnostic coverage:
• Fewer than a third had genetic tests or imaging; consequently, almost all surgeries removed most of the pancreas.

Operative and Post‑operative Findings

Mortality and Follow‑up

• 1‑year mortality: 9 % of children.
• Deaths linked to recurrent hypoglycaemia: 2 cases.

Implications

The study demonstrates that surgery can preserve life even without advanced diagnostics or a broad drug arsenal, yet it underscores the critical need for:

1. Improved diagnostic infrastructure (genetic testing, imaging).
2. Reliable supply of essential medications, particularly diazoxide.
3. Multidisciplinary teams for complex CHI management.

With these enhancements, Sudan could significantly improve outcomes for infants with this rare yet severe condition.